Elder abuse in Lebanese primary care: prevalence and predictors from a cross-sectional study.
Lewaa Shoujaa, Marwan Azzam, Lina Abdouni, Reine Obeid, Danielle Mattar, Jana Ahmad, Wael Chami, Elie Toni Korbani, Jinan Usta, Umayya Musharrafieh, Georges Assaf
Abstract
Open AccessBACKGROUND: Elder abuse is a growing public health concern with significant physical, psychological, and social consequences. In Lebanon, limited data on its prevalence and risk factors necessitate further investigation. This study estimated the prevalence of elder abuse among community-dwelling older adults in a primary healthcare setting in Lebanon and identified associated risk factors. METHODS: We conducted a cross-sectional study over 12 months at the outpatient Department of Family Medicine of the American University of Beirut Medical Center. We recruited participants aged 60 years and older and collected data on sociodemographic characteristics, frailty status, cognitive and psychological assessments, and elder abuse screening. We categorized abuse as physical, psychological, financial, and neglect-related mistreatment. We used descriptive statistics and multivariate logistic regression to identify risk factors. RESULTS: Among 249 community-dwelling older adults, 19.7% (n = 49) reported at least one form of elder abuse. Psychological abuse was most common (16.1%), followed by neglect (8.8%), physical abuse (2.4%), and financial abuse (2.0%). Frailty independently increased the odds of abuse compared to robust individuals. Receiving financial support from children was independently associated with lower odds of abuse, while financial support from a spouse showed a borderline protective effect. Participants cared for by daughters or sons had significantly greater odds of reporting abuse compared to those cared for by a spouse. Each additional year of age corresponded to a 13% decrease in the odds of abuse. CONCLUSIONS: Elder abuse is prevalent in Lebanese primary care, with psychological abuse the most reported type. Frailty, financial instability, and caregiving dynamics significantly influence abuse risk. Primary care systems should integrate routine abuse and frailty screening, strengthen caregiver support, and develop reporting pathways suitable for low-resource settings.